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Obstetrical Pathophysiology of Cocaine
Published in Richard J. Konkol, George D. Olsen, Prenatal Cocaine Exposure, 2020
J. Christopher Glantz, James R. Woods
Cocaine, or benzoylmethylecgonine, is an alkaloid of the local anesthetic “caine” group of drugs. Cocaine hydrochloride is a white, water-soluble powder which can be injected, ingested, or absorbed across mucus membranes such as the nasal mucosa, vagina, or rectum. Because it is heat labile, cocaine hydrochloride cannot be smoked. Administration is most commonly through the nasal mucosa, for which bioavailability is 60 to 80%.2–4 The plasma half-life of cocaine in humans is approximately 60±30 minutes.3,5 Approximate doses range from 20 mg I.V. to 100 mg nasal, with resultant serum levels between 125 and 475 ng/m1.1,3,6 Because of tolerance with chronic use, higher doses become necessary to achieve the same euphoric effect.
Toxicology
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Cocaine hydrochloride is a fine white powder, which may be mixed with baking soda to make ‘crack’ (free base cocaine) and smoked. It rapidly reaches the cerebral circulation and has a half-life of 90 min.
Stimulants
Published in G. Hussein Rassool, Alcohol and Drug Misuse, 2017
With oral administration, cocaine takes approximately 30 minutes to enter the bloodstream. Given the uptake of cocaine in the bloodstream and the slow rate of absorption, the effects are reached approximately 60 minutes after cocaine is administered and these effects are prolonged for approximately 60 minutes after their peak is attained. “Snorting”, sniffing”, or “blowing” (insufflations) is the most common method of ingestion of cocaine. Snorting cocaine produces maximum physiological effects within 40 minutes and an activation period is between five to 10 minutes, which is similar to oral use of cocaine. Compared to ingestion, the faster absorption of snorting cocaine results in rapid onset of maximum drug effects. With smoking freebase the cocaine is absorbed immediately into the blood, reaching the brain in about five seconds. The intensity of the “rush” is more powerful than snorting the same amount of cocaine nasally, but the effects are short-lived. The peak of the freebase rush is rapid and the high typically lasts five to 10 minutes afterward. These effects are similar to those that can be achieved by injecting cocaine hydrochloride, but without the risks associated with injecting.
Polydrug Use and Co-occurring Substance Use Disorders in a Respondent Driven Sampling of Cocaine Base Paste Users in Santiago, Chile
Published in Journal of Psychoactive Drugs, 2022
Carla F. Olivari, Jorge Gaete, Nicolás Rodriguez, Esteban Pizarro, Paloma Del Villar, Esteban Calvo, Alvaro Castillo-Carniglia
Multiple substance use patterns of CBP in Chile is similar to that described among crack or smokable cocaine users in other countries (da Cunha, Araujo, and Bizarro 2015; Gossop, Manning, and Ridge 2006; Santos Cruz et al. 2013; Usdan et al. 2001). For example a study in Brazil, in which they often use the term crack to refer to CBP, though they are not distinguishable by toxicology or composition, showed that crack cocaine users had a high prevalence of co-occurring SUDs, with alcohol, marijuana, and cocaine hydrochloride most frequently consumed concurrently with crack. This study also documented that, as with CBP, crack cocaine use initiation occurs in early adulthood (da Cunha, Araujo, and Bizarro 2015). Another study in the United Kingdom found that, compared to cocaine hydrochloride users, crack cocaine users reported a higher frequency of monthly drug use (mean of 8.5 and 21.5 days, respectively) and a remarkably higher prevalence of polydrug use (Gossop, Manning, and Ridge 2006). Additional drugs most often used by crack cocaine users were alcohol, marijuana, cocaine hydrochloride, heroin, and benzodiazepines (Gossop, Manning, and Ridge 2006).
Factors associated with the absence of cocaine craving in treatment-seeking individuals during inpatient cocaine detoxification
Published in The American Journal of Drug and Alcohol Abuse, 2021
Jose Pérez de los Cobos, Saul Alcaraz, Antonio Verdejo-García, Laura Muñoz, Núria Siñol, Maria José Fernández-Serrano, Pilar Fernández, Ana Martínez, Santiago Duran-Sindreu, Francesca Batlle, Joan Trujols
This study has three main limitations. First, we cannot rule out limitations in detecting craving absence. To achieve a balance between sensitivity and specificity to detect naturally-occurring craving, we asked patients to indicate the intensity and frequency of any desire or urge for cocaine experienced during the last 24 h on two instruments (modified VAS), both of which are included in a specific tool (the CSSA) designed to assess cocaine withdrawal. More research is needed to determine whether other approaches to measuring cocaine craving – that is, in terms of complexity and frequency of assessment – would yield similar findings to those obtained in this study. Second, despite the relevance of cocaine withdrawal for cocaine craving during detoxification, this variable was not included among the candidate predictors of absence of craving because we are not aware of any validated cocaine withdrawal assessment instrument that does not include craving as one of the items. Finally, the findings of this study may not be applicable to patients who predominantly use cocaine-free base (inhaled) or intravenous cocaine hydrochloride rather than intranasal cocaine hydrochloride (as was the case for the participants in this study) given the relevance of recent cocaine exposure for absence of craving.
Faking it: the use of imitation drugs in research interviews
Published in Journal of Substance Use, 2020
The identification of material to form a crack substitute was more difficult than that of the heroin powder. Crack cocaine is almost 100% cocaine base – approximately 90% cocaine base, with 10% or less sodium bicarbonate (Jones, 1990) (Other methods used to produce freebase cocaine, including those using ammonia, do not result in the presence of sodium bicarbonate although these are less commonly used (Siegel, 1992)). It may also contain various impurities (that were present in the cocaine hydrochloride powder from which it was produced) that have been incorporated within it during the manufacturing process.